Effect of Cool Spray and Cold Packs in Reducing Preoperative Edema and Pain in Ankle Fractures in Ubonratchathani: 3-arm Parallel-group RCT

Fractures of the ankle bone are one of the common types of bone fractures found in the general population, accounting for approximately 14% of all fractures They are often found in middle-aged males aged 15-24 years who engage in high-impact physical activities such as sports or high-intensity exercise. They are also found in elderly females with osteoporosis aged 75-84 years The incidence of ankle fractures is 187 per 100,000 population per year Ankle bone fractures usually occur due to excessive force or weight bearing. The main causes of ankle bone fractures can be categorized into three age groups: falls account for up to 61% in the elderly population, sports injuries or repetitive movements in sports or exercises can lead to pain, swelling, and bruising around the ankle joint, or the ankle may appear deformed, which is commonly found in younger age groups, accounting for 22%, and accidents from motor vehicle collisions account for 17% Unimalleolar ankle fractures are the most common type, accounting for 70% of all ankle fractures. Bimalleolar fractures account for approximately 20%, while trimalleolar fractures account for about 7% of all ankle fractures Initial management of ankle injuries involves using the RICE approach, which includes applying ice (I = ice) to the injured area. Cooling the skin with ice packs is a widely used traditional method of caring for injured patients. It has been found that when the skin temperature of bruised areas is reduced below 13.6 degrees Celsius with ice packs, swelling and pain in ankle injuries can be effectively reduced Prolonged use of ice packs for more than 6 days after injury can delay surgery and accelerate tissue recovery after surgery Additionally, studies comparing the effectiveness of reducing swelling in ankle tissue injuries with cold spray and ice packs have found that cold spray is 2-3 times more effective than ice packs in reducing swelling and pain in patients with ankle fractures both before and after surgery However, there has been no study in Thailand on effective cooling methods to reduce swelling and alleviate pain in ankle fractures. Therefore, this research aims to compare the effectiveness of using ice packs and cold spray in reducing swelling and pain before surgery in patients with ankle fractures treated at Sunpasitthiprasong Hospital, Ubon Ratchathani. It is hypothesized that cooling with ice packs and cold spray is effective in reducing swelling and pain in patients with ankle fractures before surgery, and that the effectiveness of ice packs and cold spray in reducing swelling and pain in patients with ankle fractures before surgery differs. This study aims to provide data for developing effective methods and guidelines to reduce swelling and pain in patients with ankle fractures before surgery and may be applied as an alternative option to reduce swelling and pain in patients with fractures in other parts of the body.